Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Oct 2012
Randomized Controlled TrialFentanyl co-administration decreases the induction dose requirement of propofol in patients with supratentorial tumors and not in patients with spinal lesions.
The requirement of anesthetic drugs in a patient with an intracranial space-occupying lesion is of relevance to the neuroanesthetist. The requirement is often presumed to have reduced or at least altered. However, not much research has focused on this issue. Hence, we conducted this study to examine whether intracranial tumors reduce the induction dose of propofol in patients undergoing craniotomy based on plasma and effect site concentrations (Ce) of propofol and the effect of additional fentanyl. ⋯ Propofol dose for induction of anesthesia was significantly reduced when administered after fentanyl in patients with supratentorial tumors. Tumors per se without fentanyl coadministration do not decrease the propofol requirement for induction of anesthesia.
-
J Neurosurg Anesthesiol · Oct 2012
Review Meta AnalysisPediatric anesthesia and neurodevelopmental impairments: a Bayesian meta-analysis.
Experimental evidence of anesthesia-induced neurotoxicity has caused serious concern about the long-term effect of commonly used volatile anesthetic agents on young children. Several observational studies based on existing data have been conducted to address this concern with inconsistent results. We conducted a meta-analysis to synthesize the epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children. ⋯ The most likely adjusted OR from a future study was estimated to be 1.5 (95% CrI, 0.5-4.0). We conclude that existent epidemiologic evidence suggests a modestly elevated risk of adverse behavioral or developmental outcomes in children who were exposed to anesthesia/surgery during early childhood. The evidence, however, is considerably uncertain.